Physician

Payment of Part B premiums for Specified Low-Income Medicare Beneficiaries
who:
o Have resources similar to QMBs; and
o Have incomes that are below 120 percent of the FPL; and
Payment of Part A premiums for Qualified Disabled and Working Individuals
(QDWI) who:
o Previously qualified for Medicare due to disability but lost entitlement
because of their return to work (despite the disability);
o Have incomes that are below 200 percent of the FPL; and
o Do not meet any other Medicaid assistance category.
QDWIs who do not meet these income guidelines may purchase Medicare Part A and
Part B coverage.
Medicare covered services are paid first by the Medicare Program since Medicaid is
always the payer of last resort.
Where to Find Additional Information About Medicaid
Additional information about Medicaid can be found at
http://www.cms.hhs.gov/MedicaidGenInfo on the CMS website.
Medigap
Medigap is a health insurance policy sold by private insurance companies to fill gaps in
Original Medicare Plan coverage. A Medigap policy is not associated with a labor or
union organization. Beneficiaries must be enrolled in Medicare Part A and Part B in
order to purchase a Medigap policy and, under certain circumstances, are guaranteed
the right to buy a policy. Beneficiaries may authorize a reassignment of benefits on a
claim-by-claim basis for participating providers and suppliers to file a claim for
reimbursement of Medicare services and coinsurance amounts.
Where to Find Additional Information About Medigap
Additional information about Medigap can be found at http://www.cms.hhs.gov/Medigap
on the CMS website.
Railroad Retirement
Some Medicare beneficiaries who are retired railroad workers have supplementary
medical insurance benefits from the Railroad Retirement Board.
Medicare Physician Guide: A Resource for Residents, Practicing Physicians and Other Health Care Professionals 43